Simon Wallace, chief clinical information officer, Nuance writes about the technology being used in the NHS to improve patient care.
The NHS is under tremendous and unrelenting strain. Its dedicated staff strive to deliver world-class services against the backdrop of increasing demand for services from a growing and ageing population and constrained budgets.
A Nuffield Trust report forecasts that such population growth could mean we need another 17,000 hospital beds by 2022. The number of doctors, nurses, other healthcare professionals and equipment will all have to scale to meet such demand. More patients generate more clinical documentation – the creation of which is a process that has the potential to remove clinicians from performing vital services in favour of carrying out time-sapping administration.
The time spent on clinical documentation has been highlighted in a study from Nuance Communications. It reveals that 50% or more of a doctor´s time is spent on clinical documentation processes, with around 52 minutes per day spent searching for information. A recent Freedom of Information request made on behalf of Nuance Communications also found that – for 9 in 10 Trusts questioned – administrative time is often spent by staff handwriting patient notes following consultations.
The NHS continues to invest in the digitisation of clinical documentation as part of the government’s vision for a paperless NHS by 2020 as declared in its 2014 Five Year Forward View. The report states: “All patient and care records will be digital, real-time and interoperable by 2020. By 2018 clinicians in primary, urgent and emergency care and other key transitions of care contexts will be operating without needing to use paper records”.
For this commitment to become a reality, healthcare leaders need to think not only of investing in digital technologies but also the usability of these technologies by their clinicians.
Turning the vision into a reality
One NHS Trust that is leading the way in terms of harnessing digital technology is Worcestershire Health and Care (Worcester). One of seven mental health trusts chosen as a Global Digital Exemplar (GDE), Worcester won funding to equip the healthcare workforce with an easy to use tool to support remote working, reduce clinical documentation workload, eliminate the backlog of reporting associated with detailed patient records and replace legacy, slow analogue dictation workflows with the goal of freeing up healthcare workers to focus on patient care.
Worcester’s project team prioritised the rollout of speech recognition amongst the specialties suffering from the greatest burden of paperwork and backlog of administration. These teams are required to make extensive notes to capture the patient story and the context of their patients’ care. These notes are vital in communication with colleagues in multi-disciplinary health and care teams to ensure continuity of care and to meet child protection, medico-legal and other social care requirements.
With no back-office administration support, many of the team were spending long hours capturing patient records, writing GP letters and other clinical documentation. The results of this were employees going home late or producing abbreviate notes which in turn were difficult for others to interpret or caused duplication of effort.
Enhanced patient relationships
Deploying speech recognition technology – alongside the development of bespoke templates and forms unique to each specialty – healthcare professionals could speed up note capturing, reduce repetition and support standardisation across departments. One occupational therapist even caught up with a backlog of two years’ worth of patient records in just three weeks.
Taking the onus away from administration frees up clinicians to spend more time doing exactly what they signed up for – treating patients in need. Clinicians are incredibly busy, and their top priority is always patient care. Documentation is vitally important in tracking any patients journey through the care system including results, actions and critical details of their medical history, but it is time consuming to complete. And more patients means more patient records. So intelligent systems that help clinicians naturally document care – so they can focus on patients – are essential to optimise clinical and financial outcomes.
By investing in deploying speech recognition technology across Trusts – and equipping staff with access to the technology and dedicated areas to use it – staff are enabled to deliver faster, more accurate reports, all of which underpins a better quality of patient service.